We are applying for a continuation grant for the study of changes in homicide and accidental fatal drug overdoses. Continuing our long term collaboration with the New York City Medical Examiner, we will collect and analyze data from 2000 to 2006 on an estimated 30,000 fatal injuries, which added to our data base of 40,000 fatalities over 10 years, will allow us to analyze 70,000 fatalities over a 17 year period from 1990-2006. Our data set is unique in that it contains information on types of fatal injuries, time and place of injury and death, characteristics and residence of the victim, and toxicology results for a wide range of illicit drugs and alcohol. This will enable us to extend our surveillance of homicide and overdose mortality in NYC and to test etiologic hypotheses regarding these two causes of death. Our aims are: 1) To determine the incidence, temporal trends, and correlates of homicide, accidental drug overdoses and other fatal accidents with a focus on identifying the emerging role of newer drugs such as ecstasy and oxycodone. 2) To determine neighborhood-level determinants of homicide (e.g., drug use, policing, concentrated disadvantages) and to assess how they are related to changes in the frequency of homicide over timw and place. 3) To determine the association between individual drug use, age of decedents, neighborhood factors (e.g., economic disadvantage, level of illicit drug use), and the risk of becoming a homicide case using fatal accidents as controls. 4) To determine neighborhood-level determinants of drug overdose and to assess how these are related to changes in fatal drug overdose over time and place. There have been significant changes in the use of illicit drugs, the frequency of homicide and of fatal drug overdoses in NYC over the past decade. Although there are many theories as to why these changes have occurred, few scientific studies have been able to address the key hypotheses regarding these changes. Some of the questions that can be addressed in this proposal include: Have arrests for "quality of life" crimes restored public order and lowered the frequency of homicide ad changed drug-dealing? Has individual use of certain illicit drugs increased the risk for homicide and fatal drug overdose? We intend our findings to be helpful to public health and law enforcement practice.